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Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients : the DecubICUs study

(2021) INTENSIVE CARE MEDICINE. 47(2). p.160-169
Author
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Abstract
Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score < 19, ICU stay > 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat.
Keywords
Critical Care and Intensive Care Medicine, RISK-FACTORS, ULCERS, MORTALITY, STATE, COST, Decubitus epidemiology, ICU, Pressure injury, Pressure ulcer, Outcome, Risk factors, Morbidity, Mortality

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MLA
Labeau, Sonia, et al. “Prevalence, Associated Factors and Outcomes of Pressure Injuries in Adult Intensive Care Unit Patients : The DecubICUs Study.” INTENSIVE CARE MEDICINE, vol. 47, no. 2, 2021, pp. 160–69, doi:10.1007/s00134-020-06234-9.
APA
Labeau, S., da Palma Afonso, E., Benbenishty, J., Blackwood, B., Boulanger, C., Brett, S. J., … the European Society of Intensive Care Medicine (ESICM) Trials Group Collaborators, [missing]. (2021). Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients : the DecubICUs study. INTENSIVE CARE MEDICINE, 47(2), 160–169. https://doi.org/10.1007/s00134-020-06234-9
Chicago author-date
Labeau, Sonia, Elsa da Palma Afonso, Julie Benbenishty, Bronagh Blackwood, Carole Boulanger, Stephen J. Brett, Silvia Calvino-Gunther, et al. 2021. “Prevalence, Associated Factors and Outcomes of Pressure Injuries in Adult Intensive Care Unit Patients : The DecubICUs Study.” INTENSIVE CARE MEDICINE 47 (2): 160–69. https://doi.org/10.1007/s00134-020-06234-9.
Chicago author-date (all authors)
Labeau, Sonia, Elsa da Palma Afonso, Julie Benbenishty, Bronagh Blackwood, Carole Boulanger, Stephen J. Brett, Silvia Calvino-Gunther, Wendy Chaboyer, Fiona Coyer, Mieke Deschepper, Guy François, Patrick M. Honore, Radmilo Jankovic, Ashish K. Khanna, Mireia Llaurado-Serra, Frances Lin, Louise Rose, Francesca Rubulotta, Leif Saager, Ged Williams, Stijn Blot, [missing] on behalf of the DecubICUs Study Team, and [missing] the European Society of Intensive Care Medicine (ESICM) Trials Group Collaborators. 2021. “Prevalence, Associated Factors and Outcomes of Pressure Injuries in Adult Intensive Care Unit Patients : The DecubICUs Study.” INTENSIVE CARE MEDICINE 47 (2): 160–169. doi:10.1007/s00134-020-06234-9.
Vancouver
1.
Labeau S, da Palma Afonso E, Benbenishty J, Blackwood B, Boulanger C, Brett SJ, et al. Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients : the DecubICUs study. INTENSIVE CARE MEDICINE. 2021;47(2):160–9.
IEEE
[1]
S. Labeau et al., “Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients : the DecubICUs study,” INTENSIVE CARE MEDICINE, vol. 47, no. 2, pp. 160–169, 2021.
@article{8677901,
  abstract     = {Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients.

Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis.

Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score < 19, ICU stay > 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3).

Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat.},
  author       = {Labeau, Sonia and da Palma Afonso, Elsa and Benbenishty, Julie and Blackwood, Bronagh and Boulanger, Carole and Brett, Stephen J. and Calvino-Gunther, Silvia and Chaboyer, Wendy and Coyer, Fiona and Deschepper, Mieke and François, Guy and Honore, Patrick M. and Jankovic, Radmilo and Khanna, Ashish K. and Llaurado-Serra, Mireia and Lin, Frances and Rose, Louise and Rubulotta, Francesca and Saager, Leif and Williams, Ged and Blot, Stijn and on behalf of the DecubICUs Study Team, [missing] and the European Society of Intensive Care Medicine (ESICM) Trials Group Collaborators, [missing]},
  issn         = {0342-4642},
  journal      = {INTENSIVE CARE MEDICINE},
  keywords     = {Critical Care and Intensive Care Medicine,RISK-FACTORS,ULCERS,MORTALITY,STATE,COST,Decubitus epidemiology,ICU,Pressure injury,Pressure ulcer,Outcome,Risk factors,Morbidity,Mortality},
  language     = {eng},
  number       = {2},
  pages        = {160--169},
  title        = {Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients : the DecubICUs study},
  url          = {http://dx.doi.org/10.1007/s00134-020-06234-9},
  volume       = {47},
  year         = {2021},
}

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